Degenerative mitral valve stenosis: Diagnosis and management

Q: What is the clinical evidence from this study?

Study design: Review. Population: Degenerative mitral valve stenosis.

Ahmad Al‐Taweel; Mohamed Faher Almahmoud; Yasmine Khairandish; Masood Ahmad

doi:10.1111/echo.14495

October 1, 2019Echocardiography

Degenerative mitral valve stenosis: Diagnosis and management

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Key result

Review outlines the pathophysiology, diagnosis, and medical, surgical, and transcatheter management of degenerative mitral stenosis.

Why the study?

Degenerative mitral stenosis is increasingly prevalent in the elderly, yet accurate assessment of mitral valve area in patients with mitral annular calcification remains challenging due to altered atrial and valvular structures and comorbidities.

Key Points

To review the epidemiology, pathophysiology, diagnostic evaluation, and therapeutic options for degenerative mitral stenosis in comparison with rheumatic mitral stenosis.
Synthesized clinical evidence on the presentation, etiology, and progression of degenerative mitral stenosis (DMS) stemming from mitral annular calcification (MAC).
Compared diagnostic imaging challenges and structural changes in DMS against classical rheumatic mitral stenosis.
Evaluated medical management, conventional surgical approaches, and emerging transcatheter intervention techniques.
DMS primarily manifests as a late stage of mitral annular calcification, exhibiting rising prevalence among aging populations in developed countries.
Assessment of mitral valve area is frequently compromised by severe anatomical distortion and multiple coexisting comorbidities.
Therapeutic strategies are evolving from conventional surgical and medical pathways toward advanced transcatheter valvular interventions suitable for high-risk elderly patients.

Structured PICO

P

Population

Elderly patients with degenerative mitral stenosis (DMS) and mitral annular calcification (MAC)

This review summarizes the epidemiology, diagnosis, and management of degenerative mitral stenosis, highlighting the challenges in assessment and the latest therapeutic approaches.

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Implication

Offers synthesis of degenerative mitral stenosis care; leaves open need for prospective trials on transcatheter options.

Abstract

Mitral stenosis (MS) is a common valvular disease characterized by narrowing of the mitral valve orifice and a reduction in mitral valve area (MVA). While rheumatic MS (RMS) is frequently encountered in young individuals in developing countries, degenerative MS (DMS) is seen in the elderly in developed countries and its prevalence is increasing. DMS is usually a late presentation of mitral annular calcification (MAC). Accurate assessment of MVA in patients with MAC is challenging due to the alterations in the atrial and valvular structures as well as the presence of other comorbidities in this aging population. We will review the epidemiology, etiology, pathophysiology, diagnostic assessment, and management of DMS and compare the findings with RMS. The latest therapeutic approaches, including medical, surgical, and transcatheter valvular interventions, will be discussed.

Discussion

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Cite This Study

Al‐Taweel et al. (2019) conducted a review in Degenerative mitral valve stenosis. This review outlines the epidemiology, pathophysiology, diagnostic assessment, and management of degenerative mitral valve stenosis, including medical, surgical, and transcatheter interventions.

synapsesocial.com/papers/6a0d6c61cb02dac523a4d85d https://doi.org/10.1111/echo.14495

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Degenerative mitral valve stenosis: Diagnosis and management

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Degenerative mitral valve stenosis: Diagnosis and management

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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